DOCSLIB.ORG

Glenohumeral Osteoarthritis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Glenohumeral Osteoarthritis M MISCELLANEOUS Shoulder & Elbow 2016, Vol. 8(3) 203–214 ! The Author(s) 2016 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1758573216644183 sel.sagepub.com BESS/BOA Patient Care Pathways Glenohumeral osteoarthritis Michael Thomas, Amit Bidwai, Amar Rangan, Jonathan L Rees, Peter Brownson, Duncan Tennent, Clare Connor and Rohit Kulkarni Introduction Continuity of care Definition Continuity and co-ordination of care are essential parts of the General Medical Council’s Good Medical Degenerative shoulder (glenohumeral) osteoarthritis is Practice guidance.2 It is therefore inappropriate for a characterized by degeneration of articular cartilage and clinician to treat a patient if there is no clear commit- subchondral bone with narrowing of the glenohumeral ment from that clinician or the healthcare provider to joint. It causes significant pain, functional limitation oversee the complete care pathway of that patient, and disability with an estimated prevalence of between including their diagnosis, treatment, follow-up and 4% and 26%.1 adverse event management. Shared decision-making Background The General Medical Council’s Good Medical Practice The prevalence of shoulder complaints in the UK is – Duties of a Doctor guide2 clearly states in the section estimated to be 14%, with 1% to 2% of adults over on working in partnership with patients that doctors the age of 45 years consulting their general practitioner should: annually regarding new-onset shoulder pain.3 Shoulder osteoarthritis is the underlying cause of shoulder pain . Listen to patients and respond to their concerns and in 2% to 5% of this group, although few truly popula- preferences. tion-based studies have been conducted.1,4 . Give patients the information they want or need in a Painful shoulders pose a substantial socio-economic way they can understand. burden. Disability of the shoulder can impair ability to . Respect patients’ right to reach decisions with the work or perform household tasks and can result in time doctor about their treatment and care. off work.4,5 Shoulder problems account for 2.4% of all . Support patients in caring for themselves to improve general practitioner consultations in the UK and 4.5 and maintain their health. million visits to physicians annually in the USA.6,7 There are a number of occupational risk factors that This can only be achieved by direct consult- may be relevant in the development of shoulder pain ation between the patient and their treating but the available evidence is inconsistent and the clinician. Decisions about treatment taken without such direct consultation between patient Corresponding author: and treating clinician are not appropriate because Michael Thomas, Heatherwood Hospital, London Road, Ascot, they do not adhere to principles of good medical Berkshire, SL5 8AA, UK. practice. Email: [email protected] Downloaded from sel.sagepub.com at St George's Healthcare NHS Trust on June 9, 2016 204 M Shoulder & Elbow 8(3) Red flags for the shoulder associations are are not strong.8 The annual financial burden of shoulder pain management has been esti- Acute severe shoulder pain needs proper and competent mated to be US$3 billion.8 diagnosis. Any shoulder ‘red flags’ identified during pri- mary care assessment needs urgent secondary care referral. Glenohumeral arthritis: care pathway Aims of treatment . A suspected infected joint needs same day urgent referral. The overall treatment aim for shoulder osteoarthritis is . An unreduced dislocation needs same day urgent to relieve pain and improve function. Treatment success referral. needs to be defined individually with patients in a . Suspected malignancy or tumour needs urgent refer- shared decision-making process. ral following the local two-week cancer referral pathway. Pre-primary care (at home) . Suspected inflammatory oligo or poly-arthritis or systemic inflammatory disease should be considered For causes of glenohumeral shoulder pain, there is as a ‘rheumatological red flag’ and local rheumatol- potential for simple patient self-management strategies ogy referral pathways should be followed. and prevention strategies at home prior to the need for a general practitioner consultation, although research to develop and assess the impact of such strategies Treatment in primary care and community triage would be needed. services . Treatment depends on the severity of symptoms and Primary care/community triage services degree of restriction of work, domestic and leisure activities. The aims of treatment are: . Diagnosis is based on History and Examination (see Pain relief Figure 1, which gives guidance on treatment and Improving range of motion referral). Reducing duration of symptoms . Making the correct diagnosis is crucial, and will Return to normal activities ensure an efficient and optimum treatment for the . The following interventions are suitable for primary patient. care: . Plain radiographs of the shoulder are essential for Analgesics/non-steroidal anti-inflammatory drugs confirming the diagnosis. True anteroposterior view (NSAIDs) (in scapular plane) and axillary view are recom- Local injections mended for this purpose. Specialist imaging such Acupuncture as magnetic resonance imaging (MRI) or computed Physical therapy tomography (CT) scans are not indicated for . This is a painful and debilitating condition, where treatment of glenohumeral osteoarthritis in primary the pain is often severe. The onset of stiffness is care. progressive over many years and will cause signifi- cant functional deficit, typically presenting in Features of importance are; patients over 60 years of age, where 32% of patients have been reported to have shoulder . Hand dominance. arthritis.9 . Occupation and level of activity or sports. Treatment should be tailored to individual patients’ . Location, radiation and onset of pain. needs depending on response and severity of . Duration of symptoms. symptoms. Global reduction in range of motion, especially . Beware of red flags such as tumour, infection, unre- severe loss of passive external rotation in the affected duced dislocation, or inflammatory polyarthritis. shoulder with arm by the side. Most patients with established osteoarthritis will . History of multiple joint involvement or systemic respond poorly to conservative treatment. The manifestations. most frequent indications for invasive treatments . X-rays to confirm glenohumeral arthritis, avascular are pain and persistent and severe functional restric- necrosis or dislocation of the shoulder, which pro- tions that are resistant to conservative measures. duce a similar clinical picture. X-rays are essential if . Failure of functional adaptation should trigger refer- there is history of significant trauma. ral for consideration of surgical options. Downloaded from sel.sagepub.com at St George's Healthcare NHS Trust on June 9, 2016 M Thomas et al. 205 . Shared decision-making is important, and individual contracted capsule. This potentially may reduce patients’ needs are different. Failure of initial treat- pain and improve range of movement. This proced- ment to control pain, if degree of stiffness causes ure may be appropriate for younger patients with considerable functional compromise, or if there is early arthritis. any doubt about diagnosis, prompt referral to sec- . Suprascapular nerve block can be performed by ondary care is indicated. either by single or series of injections or by nerve ablation (percutaneous or arthroscopic) and is a purely pain relieving intervention. It is thought Secondary care that the suprascapular nerve is sensory to the shoul- der capsule and nerve block therefore reduces symp- . In a UK study of patterns of referral of shoulder toms of pain. This intervention is not an alternative conditions, 22% of patients were referred to to shoulder replacement for definitive treatment of secondary care up to 3 years following initial pres- arthritis. entation, although most referrals occurred within 3 . Biological glenoid resurfacing is a technique used months.9 particularly in younger patients. This can be in con- . Confirm diagnosis with history and examination. junction with a shoulder hemiarthroplasty in order . Obtain imaging with plain radiographs to confirm to avoid the insertion of a glenoid component. The the diagnosis of glenohumeral osteoarthritis, to technique can also be performed arthroscopically. rule out other differentials such as avascular necrosis Described methods include the use of biological of humeral head (without arthritis) or dislocation material, for example meniscal allograft or semi-syn- and to exclude other pathology that might also be thetic material using typically human dermis or contributing to the shoulder pain such as acromio- alternative xenografts as an interposition arthro- clavicular joint arthritis. Specialist imaging with plasty, glenoid microfracture or a glenoid reaming ultrasound, CT or MRI scans may be indicated for debridement technique. evaluation of the state of the rotator cuff and bone . Hemiarthroplasty, TSR and reverse shoulder stock as well as to aid pre-operative planning. replacement are arthroplasty procedures performed . Counsel patient fully regarding surgical and nonsur- under general anaesthesia with or without regional gical options. anaesthesia. They may be stemmed, stemless or res- . Ensure multidisciplinary approach to care with urfacing and may be cemented, uncemented or a availability of specialist physiotherapists and shoul- combination of both. Hemiarthroplasty addresses
Load more

Recommended publications
  • Information for Patients About Shoulder Surgery
    Information for Patients about Shoulder Surgery Clinical Professor Allan Wang FRACS PhD FAOrthA Shoulder and Upper Limb Surgeon www.allanwangorthopaedics.com.au MURDOCH SUBIACO Murdoch Orthopaedic Clinic St John of God Subiaco Clinic St John of God Murdoch Clinic Suite 302, 25 McCourt St Suite 10, 100 Murdoch Drive Subiaco WA 6008 Murdoch WA 6150 Telephone: 08 6332 6390 Page | 2 Information for Patients about Shoulder Surgery Introduction e hae put this information boolet together to eduate our atients about their shoulder condition treatment otions and ost-surgial care Please ee this boolet for future referene It is not a detailed soure of information and you may also ish to refer to our ebsite www.allanwangorthopaedics.com.au for animated ideos of surgial roedures If you reuire further information or hae onerns regarding your treatment lease ontat the offie to disuss ith r ang or his staff Contents Pages 1. Shoulder natomy 3 2. Shoulder Imingement and otator Cuff endon isorders 4 3. Shoulder oint Instability and abrum ears 7 4. Post eratie Instrutions a. romiolasty eision 10 b. otator uff Reair 12 Bankart abrum Reair 5. roen Shoulder dhesie asulitis 17 6. Total Shoulder Joint elaement 19 Page | 3 Shoulder Anatomy Bone and oints of the houlder Important uscle Groups of the Shoulder Page | 4 Shoulder mpingement and otator uff Tendon isorders What is Impingement Syndrome? The moement o the houlder ont deendent on the urroundn mule and tendon - the rotator cu comlex. he rotator u comre o our tendon Suranatu tendon the mot reuently damaed tendon ecaue hen the arm eleated the tendon can ru mne aant the underurae o the aromon one at the to o the shoulder.
    [Show full text]
  • Osteoarthritis of the Shoulder
    John G. Costouros, MD FACS John G. Costouros, MD FACS Chief of Shoulder Surgery Chief of Shoulder Surgery Shoulder Arthroscopy, Reconstruction, Sports Medicine Shoulder Arthroscopy, Reconstruction, Sports Medicine www.californiashoulder.com www.californiashoulder.com OSTEOARTHRITIS OF THE SHOULDER Glenohumeral (shoulder) arthritis is a common source of pain and disability that affects up to 20% of the older population. Damage to the cartilage surfaces of the glenohumeral joint (the shoulder’s “ball-and-socket” structure) is the primary cause of shoulder arthritis. There are many treatment options for shoulder arthritis, ranging from anti-inflammatory medications and exercises for mild cases, to surgical procedures for severe cases. Treatment decisions are based upon the cause, the symptoms and the severity of the patient’s disease. Each year, over 120,000 shoulder replacement surgeries are performed in the United States to relieve pain and improve function for shoulders that are severely damaged by glenohumeral arthritis. The shoulder is the most mobile joint in the human body with a complex arrangement of structures working together to provide the movement necessary for daily life. Unfortunately, this great mobility comes at the expense of stability. Several bones and a network of soft tissues (ligaments, tendons, muscles, and joint capsule), work together to produce shoulder movement. They interact to keep the joint in place while it moves through extreme ranges of motion. Each of these structures makes an important contribution to shoulder movement and stability. Certain work or sports activities can put great demands upon the shoulder, and injury can occur when the limits of movement are exceeded and/or the individual structures are overloaded.
    [Show full text]
  • Shoulder Arthritis.Indd
    Shoulder Arthritis Osteoarthritis, or “degenerative joint disease,” is the most over the head, and decreases with rest. Arthritis of the common type of arthritis in the shoulder. Less commonly G-H joint usually hurts mostly in the back of the shoulder, seen types of arthritis in the shoulder are rheumatoid while A-C arthritis hurts mostly on “top” of the shoulder at (infl ammatory) arthritis and arthritis that can occur after the end of the collar bone. shoulder trauma. The next most common complaint is loss of motion, which In osteoarthritis, the smooth cartilage that covers the tends to be more severe in people with G-H arthritis. In ends of the bones gets worn away, causing the rough addition, the motion of the shoulder can sometimes feel bone ends to rub against each other. This leads to ir- like grinding (also known as crepitus) as the bones rub on regular motion within the joint and to the development one another. of bone spurs (osteophytes), which are bony growths formed as the bone tries to heal itself. Irregular motion Fortunately, not everyone who develops arthritis devel- and bone spurs along with infl ammation can result in pain ops pain and loss of motion. In fact, some people with and loss of motion in the shoulder. severe joint destruction have very few symptoms. There are two joints within the shoulder that can be Diagnosis aff ected by osteoarthritis. The main joint that provides Arthritis of the shoulder is typically diagnosed with a most of the shoulder motion is a ball-and-socket joint physical examination and x-rays.
    [Show full text]
  • Shoulder Arthritis David M
    InfoSheet – Shoulder Arthritis David M. Klein, MD – Kennedy-White Orthopaedic Center of an inflammatory disease such as What is shoulder arthritis? rheumatoid arthritis. Arthritis is a condition that occurs in various joints in the body, especially in How do I know if I have the knees, hips, hand, and spine. It can arthritis? affect any joint, but the shoulder is The shoulder joint becomes stiff, feels affected infrequently. heavy, and fatigues easily when arthritis When arthritis occurs, the cartilage that is present. The stiffness is usually worse covers the ends of the bones making up in the morning, and can slowly improve the joint breaks down and often flakes with "warm up activities." Mechanical off into the joint. The joint becomes grinding and catching in the shoulder is swollen and stiff, and the lining tissue of a common sign of arthritis. the joint (the synovium) becomes What tests can the doctor do to overgrown. prove if arthritis is present? Most advanced cases of arthritis can be diagnosed with an x-ray evaluation of the shoulder. Sometimes, with rheumatoid or other types of "inflammatory" arthritis, special blood tests or other evaluations are needed. What is the best treatment for arthritis of the shoulder? The treatment of shoulder arthritis depends on how disabling and painful the disease is. Often your doctor will refer you to a rheumatologist who Frequently, spurs will develop around specializes in treating arthritis with the margins of the joint and can even medications. break off inside the joint. The pain from arthritis can vary from none to very Anti-inflammatory medications taken by severe, depending upon many factors, mouth can be helpful.
    [Show full text]
  • Shoulder Replacement Patient Guide Dr. Kaper
    ORTHOPAEDIC SPECIALISTS OF SCOTTSDALE Shoulder Arthroplasty/Replacement A Patient’s Guide Shoulder Replacement: A Patient’s Guide 2 Table of Contents Foreword 3 Introduction 4 Anatomy of the Shoulder 5 Surgical Overview 6 Pre-admission Evaluation 7 Helpful Hints in Preparation for Surgery 8 The Day of Your Surgery 9 After Your Surgery 10 Physical Therapy 12 Going Home 13 Shoulder Replacement Patient Precautions 14 Surgical Risks 15 Frequently Asked Questions 17 Long-term Care of Your Shoulder Replacement 18 Orthopaedic Specialists of Scottsdale www.ScottsdaleOrthoSpecialist.com Shoulder Replacement: A Patient’s Guide 3 Foreword This booklet has been developed by Dr. Kaper for his orthopaedic surgery patients at Orthopaedic Specialists of Scottsdale. It is used in conjunction with instruction from the rehabilitation and nursing staff. This booklet should not be given to patients under the care of other orthopaedic surgeons, whose surgical approaches and post-operative management of shoulder replacements may vary from his. Orthopaedic Specialists of Scottsdale www.ScottsdaleOrthoSpecialist.com Shoulder Replacement: A Patient’s Guide 4 Introduction Welcome to Orthopaedic Specialists of Scottsdale. In preparation for your surgery, we have provided you with this information booklet to help answer some of your questions and concerns about Shoulder Replacement surgery. We hope that you find this booklet helpful. If after reading this guide, you still have any concerns about the surgery, hospitalization, or other aspects, we encourage you to contact us. Our office telephone # is: 480-305-0034. Further helpful information is also available at our websites: www.ScottsdaleOrthoSpecialist.com. Please remember that each patient will respond and recover from shoulder replacement surgery according to their own individual situation.
    [Show full text]
  • Shoulder Arthritis
    COF_ShoulderInfo.qxp_Layout 1 2019-03-25 8:17 PM Page 12 Shoulder Arthritis Anatomy The shoulder complex is made up of three joints and one articulation. What we think of as the shoulder joint, referred to as the glenohumeral joint, consists of both a ball and socket. The ball, or humeral head, is much bigger than the socket, or glenoid. This joint allows the shoulder to move more than any other joint in the body. The glenoid is part of the shoulder blade, or scapula. The shoulder blade forms an articulation with the rib cage that is also called the scapulothoracic articulation. Total shoulder movement is primarily made up of the movement from both the glenohumeral joint and scapulothoracic articulation. The remaining two joints constitute the connection between the collarbone, or clavicle, and acromion on one end (acromioclavicular or AC joint), and the clavicle and sternum on the other end (sternoclavicular or SC joint). Shoulder Arthritis Arthritis can affect any of the joints in the shoulder, but it most commonly occurs in the acromioclavicular joint or in the glenohumeral joint. There are a number of different types of arthritis, each of which has non- surgical and surgical options for treatment. Types of Arthritis Osteoarthritis – Osteoarthritis is a common form of arthritis that occurs more often in the acromioclavicular joint than the glenohumeral joint. Its occurrence is due to many different factors, but is commonly thought of as “wear and tear” arthritis. The joint surfaces that are made up of smooth articular cartilage, begin to wear away, leading to bone rubbing on bone, which may cause pain, stiffness, and mechanical symptoms (e.g.
    [Show full text]
  • Reverse Total Shoulder Or Delta Shoulder for Shoulder Arthritis Combined with Massive Rotator Cuff Tear and for Failed Conventional Total Shoulder Replacement
    Shoulder & Elbow Service, University of Washington Department of Orthopaedics and Sports Medicine Reverse Total Shoulder or Delta Shoulder for Shoulder Arthritis Combined with Massive Rotator Cuff Tear and for Failed Conventional Total Shoulder Replacement Follow: shoulderarthritis.blogspot.com For questions, please email: [email protected] or [email protected]. The reverse total shoulder replacement can restore comfort and function to the arthritic shoulder combined with a massive rotator cuff tear and for failed conventional total shoulder replacement. This combination of conditions can result in major loss of stability and active motion of the shoul- der. The reverse total shoulder provides stability of the shoulder joint so that the deltoid muscle can power the shoulder through a useful range of motion. In this procedure the arthritic ball is replaced by a socket fixed to the arm bone (humerus) by a stem that fits within it.A metal ball is fixed to the bone of the arthritic socket with screws. Success requires technical excellence of the surgery and a commitment to a conservative rehabilitation program. What Are The Key Parts Of The Normal Shoulder Joint? The ball (humeral head) fits in the socket (glenoid) and is held there by the rotator cuff What Is Shoulder Arthritis? Shoulder arthritis is a condition in which de- generation, injury, inflammation or previous surgery destroys the normally smooth carti- lage on the ball (humeral head) and socket (glenoid). How Is Shoulder Arthritis Diagnosed? Carefully standardized X-rays reveal the loss of the space between the hu- meral head and glenoid that is normally occupied by cartilage, leaving bone on bone contact.
    [Show full text]
  • Shoulder Arthritis
    Shoulder Arthritis Brett Sanders, MD Center For Sports Medicine and Orthopaedic 2415 McCallie Ave. Chattanooga, TN (423) 624-2696 The shoulder is a ball-and-socket joint that enables you to raise, twist, bend, and move your arms forward, to the sides and behind you. The head of the upper arm bone (humerus) is the ball and a circular depression (glenoid) in the shoulder bone (scapula) is the socket. A soft-tissue rim (labrum) surrounds and deepens the socket. The head of the upper arm bone is coated with a smooth, durable covering (articular cartilage) and the joint has a thin, inner lining (synovium) for smooth movement. The surrounding muscles and tendons provide stability and support. Many people know someone with an artificial knee or hip joint. Less common, but just as successful in relieving joint pain, is a shoulder replacement (arthroplasty). This procedure may be recommended if arthritis or degenerative joint disease makes your shoulder stiff and painful or if the upper arm bone is fractured so badly that tissue death may result. Shoulder replacement surgery replaces damaged joint surfaces with artificial parts (prostheses). Usually, there are two components: The humeral component replaces the head of the upper arm bone. It is made of metal (usually cobalt/chromium-based alloys) and has a rounded ball attached to a stem that fits into the bone. This component comes in various sizes and can be a single piece or a modular unit. The glenoid component replaces the socket (the glenoid depression). It is made of ultrahigh density polyethelene. Some versions have a metal tray, but totally plastic versions are more common.
    [Show full text]
  • Early Follow-Up of Reverse Total Shoulder Arthroplasty in Patients Sixty Years of Age Or Younger
    1877 COPYRIGHT Ó 2013 BY THE JOURNAL OF BONE AND JOINT SURGERY,INCORPORATED Early Follow-up of Reverse Total Shoulder Arthroplasty in Patients Sixty Years of Age or Younger Stephanie J. Muh, MD, Jonathan J. Streit, MD, John Paul Wanner, BS, Christopher J. Lenarz, MD, Yousef Shishani, MD, Douglas Y. Rowland, PhD, Clay Riley, MD, Robert J. Nowinski, DO, T. Bradley Edwards, MD, and Reuben Gobezie, MD Investigation performed at University Hospitals of Cleveland, Mayfield Heights, Ohio, Fondren Orthopaedic Group, Houston, Texas, and OrthoNeuro, New Albany, Ohio Background: Reverse shoulder arthroplasty (RSA) is an accepted treatment that provides reproducible results in the treatment of shoulder arthritis and rotator cuff deficiency. Concerns over the longevity of the prosthesis have resulted in this procedure being reserved for the elderly. There are limited data in the literature with regard to outcomes in younger patients. We report on the early outcomes of RSA in a group of patients who were sixty years or younger and who were followed for a minimum of two years. Methods: A retrospective multicenter review of sixty-six patients (sixty-seven RSAs) with a mean age of 52.2 years was performed. The indications included rotator cuff insufficiency (twenty-nine), massive rotator cuff disorder with osteoar- thritis (eleven), failed primary shoulder arthroplasty (nine), rheumatoid arthritis (six), posttraumatic arthritis (four), and other diagnoses (eight). Forty-five shoulders (67%) had at least one prior surgical intervention, and thirty-one shoulders (46%) had multiple prior surgical procedures. Results: At a mean follow-up time of 36.5 months, mean active forward elevation of the arm as measured at the shoulder improved from 54.6° to 134.0° and average active external rotation improved from 10.0° to 19.6°.
    [Show full text]
  • Arthritis of the Shoulder Cause Symptoms
    Arthritis of the Shoulder Although most people think of the shoulder as several joints, there are really two joints in the area of the shoulder. One is located where the collarbone (clavicle) meets the tip of the shoulder bone (acromion). This is called the acromioclavicular or AC joint. The junction of the upper arm bone (humerus) with the shoulder blade (scapula) is called the glenohumeral joint or scapulothoracic joint. Both joints may be affected by arthritis. To provide you with effective treatment, your physician will need to determine which joint is affected and what type of arthritis you have. Cause Three major types of arthritis generally affect the shoulder. Osteoarthritis Osteoarthritis, or "wear-and-tear" arthritis, is a degenerative condition that destroys the smooth outer covering (articular cartilage) of bone. It usually affects people over 50 years of age and is more common in the acromioclavicular joint than in the glenohumeral shoulder joint. Rheumatoid Arthritis Rheumatoid arthritis is a systemic inflammatory condition of the joint lining, or synovium. It can affect people of any age and usually affects multiple joints on both sides of the body. Posttraumatic Arthritis Posttraumatic arthritis is a form of osteoarthritis that develops after an injury, such as a fracture or dislocation of the shoulder. Arthritis can also develop after a rotator cuff tear. Symptoms • The most common symptom of arthritis of the shoulder is pain, which is aggravated by activity and progressively worsens. • If the glenohumeral shoulder joint is affected, the pain is centered in the back of the shoulder and may intensify with changes in the weather.
    [Show full text]
  • Patient Education Shoulder Arthroplasty
    Patient Education Shoulder Arthroplasty Explanation of Procedure and Diagnosis Shoulder Arthritis The shoulder joint is essentially a ball and socket joint. However, unlike the ball and socket joint of the hip, the shoulder has much greater mobility. This mobility is dependent upon an elaborate array of muscles, tendons and ligaments that make the shoulder one of the most complex joints in the body. Shoulder Anatomy The socket of the shoulder, or glenoid, is part of the scapula (shoulder blade). The ball is on the top end of the arm bone (humerus). With the help of the muscles of the shoulder (the deltoid and rotator cuff muscles), the humerus moves and rotates within the socket raising and twisting your arm. Arthritis The most common source of shoulder pain is arthritis. In fact, more than 40 Medical Illustration © 2012 Nucleus Medical Media, Inc. million people in the Unites States suffer from some sort of arthritis. There are four main types of arthritis. 1. Osteoarthritis (or “wear and tear” arthritis) occurs when the smooth tissues on the joint surfaces (cartilage) breaks down leaving the underlying bone to grind on bone. Not only does this lead to popping and catching sensations and loss of shoulder motion, but it can also can be quite painful. 2. Rheumatoid arthritis is a systemic (whole body) disease in which all joints are susceptible. More commonly seen in women, rheumatoid arthritis is a result of the body’s immune system creating chemicals that attack and destroy the joint surfaces. 3. Traumatic arthritis may occur when the joint is injured from a fracture, ligament tear, or dislocation that may lead to disruption of the normally smooth joint surface.
    [Show full text]
  • Your Diagnosis Is Shoulder Rotator Cuff Tears/Deficiency with Or Without Glenohumeral Arthritis
    www.denvershoulder.com www.western-ortho.com Your diagnosis is shoulder rotator cuff tears/deficiency with or without glenohumeral arthritis. Humeral head has migrated upward indicating a massive rotator cuff tear Glenohumeral arthritis Xray of the shoulder joint What is the rotator cuff? The rotator cuff is a group of four tendons that originate on the shoulder blade and attach to the front, back, and top of the head of the humerus (upper arm bone) like a cuff on a shirt sleeve. These tendons are connected to short, but very important muscles that originate from the scapula. When the muscles contract, they pull on the rotator cuff tendons, causing the shoulder to rotate upward, inward, or outward, hence the name "rotator cuff." What is a rotator cuff tear or deficiency? When a sufficient enough injury to one of the rotator cuff muscles occurs, it can cause the tendon to tear. Sometimes, the tear isn’t from a specific injury, rather a tear can occur from wear and tear over time. If a tear isn’t surgically repaired and the muscles are allowed to atrophy (waste away), the rotator cuff no longer functions adequately. This is described as a rotator cuff deficiency. What is glenohumeral (shoulder) arthritis? The glenohumeral joint is the shoulder joint. It is a ball and saucer (rather than socket) joint with the ball being the head of the humerus and the saucer being the glenoid of the scapula. Shoulder (glenohumoral) arthritis Glenohumeral arthritis is a degenerative condition of the shoulder joint where the joint surface becomes inflamed.
    [Show full text]